Use modifier 57 for decision for surgery, but not for preop exam

Why This Topic Matters

Correct use of modifier 57 affects how evaluation and management services are reported around surgery. Understanding the distinction between decision-making visits and preoperative clearance helps reduce claim denials and supports compliant reporting.

Article Sections

1. Overview

   Introduces the topic and frames the article around modifier use in relation to surgical visits and preoperative exams.

2. Medicare and global period guidance

   Summarizes guidance from Medicare and related coding policy sources on reporting visits tied to surgery and the role of global periods.

3. Timing considerations around surgery

   Discusses how the timing of a visit relative to surgery affects whether additional reporting considerations apply.

4. Examples

   Provides illustrative scenarios involving ObGyn encounters and how they relate to surgical decision-making and preoperative evaluation.

5. Minor surgery

   Addresses how visits connected with procedures having shorter global periods are treated in general terms.

6. Three key points to remember about modifier 57

   Restates the article’s main takeaways about the scope, timing, and purpose of this modifier.